Methotrexate (Injection)

Methotrexate (meth-oh-TREX-ate)

Treats several kinds of cancer, including cancer of the blood, bone, lung, breast, head, or neck. Also treats rheumatoid arthritis and psoriasis (a skin disease).

Brand Name(s):

There may be other brand names for this medicine.

When This Medicine Should Not Be Used:

You should not use this medicine if you have had an allergic reaction to methotrexate or if you are breastfeeding. You should not use this medicine for arthritis or psoriasis if you are pregnant, or if you have liver disease or certain problems with your blood or immune system. Make sure your doctor knows if you drink alcohol of any kind on a regular basis.

How to Use This Medicine:

Injectable

• Medicines used to treat cancer are very strong and can have many side effects. Before receiving this medicine, make sure you understand all the risks and benefits. It is important for you to work closely with your doctor during your treatment.
• Your doctor will prescribe your exact dose and tell you how often it should be given. This medicine is given as a shot under your skin, into a muscle, into an artery, or into your spine (back or neck). Your schedule for this medicine will vary depending on your reason for using it.
• You will receive this medicine while you are in a hospital or cancer treatment center. A nurse or other trained health professional will give you this medicine.
• You may be taught how to give your medicine at home. Make sure you understand all instructions before giving yourself an injection. Do not use more medicine or use it more often than your doctor tells you to.
• Use a new needle and syringe each time you inject your medicine.

If a dose is missed:

• This medicine needs to be given on a fixed schedule. If you miss a dose, call your doctor, home health caregiver, or treatment clinic for instructions.

How to Store and Dispose of This Medicine:

• If you store this medicine at home, keep it at room temperature, away from heat, moisture, and direct light. This medicine may come as a powder or a liquid. This powder or liquid must be mixed with another, special liquid before you use it. Do not mix the medicine and the special liquid together until right before using the medicine. Ask your doctor or home health caregiver if you have questions.
• Throw away used needles in a hard, closed container that the needles cannot poke through. Keep this container away from children and pets. Follow any special instructions about how to throw away empty medicine bottles, tubes, or bags.
• Keep all medicine away from children and never share your medicine with anyone.

Drugs and Foods to Avoid:

Ask your doctor or pharmacist before using any other medicine, including over-the-counter medicines, vitamins, and herbal products.

• There are many drugs that can interact with methotrexate. Some of these drugs are aspirin, phenytoin (Dilantin®), theophylline (Theo-Dur®), antibiotics (such as penicillin, tetracycline, Bactrim®, Septra®), and vitamin supplements that contain folic acid. Make sure your doctor knows about ALL other medicines you are using.
• If you have bone cancer, ask your doctor if you need to avoid using pain or arthritis medicine (such as aspirin, diclofenac, ibuprofen, indomethacin, Advil®, Aleve®, Bextra®, Celebrex®, Vioxx®) or steroid medicines (such as prednisone).
• If you have arthritis, make sure your doctor knows about all other medicines you are using to treat arthritis (such as aspirin, gold, ibuprofen, prednisone, sulfasalazine, Azulfidine®, Celebrex®, Plaquenil®, Vioxx®).
• Make sure your doctor knows about any cancer treatments you are using, including cisplatin (Platinol®) or radiation.
• Tell your doctor if you have used methotrexate before for any reason.
• Talk to your doctor before getting flu shots or other vaccines while you are receiving methotrexate. Vaccines may not work as well while you are using this medicine.

Warnings While Using This Medicine:

• Using this medicine while you are pregnant can harm your unborn baby. The medicine may also cause birth defects if the father is using it when his sexual partner becomes pregnant. Use an effective form of birth control during treatment with methotrexate. For a man, continue birth control for at least 3 months after stopping treatment. For a woman, continue birth control until you have had two menstrual periods after stopping treatment. If a pregnancy occurs while you are using this medicine, tell your doctor right away.
• Make sure your doctor knows if you have kidney disease, liver disease, a stomach ulcer, colitis, diabetes, hepatitis, HIV or AIDS, problems with your immune system, or any kind of problem with your blood (such as anemia). Tell your doctor if you get an infection of any kind.
• This medicine may make your skin more sensitive to sunlight. Use a sunscreen when you are outdoors. Avoid sunlamps and tanning beds.Tell your doctor if you have increased skin redness or other problems.
• You may get infections more easily while you are using this medicine. Stay away from people with colds, flu, or other infections. Wash your hands often.
• Your doctor will need to check your progress at regular visits while you are using this medicine. You may need to have blood tests or other medical tests. Be sure to keep all appointments.

Possible Side Effects While Using This Medicine:

Call your doctor right away if you notice any of these side effects:

• Allergic reaction: Itching or hives, swelling in your face or hands, swelling or tingling in your mouth or throat, chest tightness, trouble breathing.
• Blistering, peeling, red skin rash
• Change in how much or how often you urinate
• Cough, fever, chest pain, trouble breathing, blue lips or fingers
• Eyes or skin turn yellow, or dark-colored urine or pale stools
• Fever
• Nausea, vomiting, diarrhea, loss of appetite, stomach pain
• Seizures, confusion, numbness, trouble seeing, headache
• Sores or white patches on your lips, mouth, or throat
• Unusual bleeding, bruising, or weakness

If you notice these less serious side effects, talk with your doctor:

• Hair loss

If you notice other side effects that you think are caused by this medicine, tell your doctor.